Legal Doping: Placebo Push onto the Winner’s Podium

21. January 2008

If only a patient is absolutely convinced about the effects of a drug, a placebo sometimes is enough to achieve the desired success of a therapy. Even athletes are not immune to the effect of phony preparations - a way how the trainer could increase the performance of his protégé during competitions - absolutely legal.

“Suffer, you bastard!” Not many sentences in professional sports have become as famous as the one Udo Bölts said to his team colleague Jan Ullrich during the Tour de France in 1997. In the eyes of the spectators, only few sports events are associated with self conquest and agony as much as the famous France tour. And hardly any sport has made so many headlines concerning doping as did cycling.

The list of drugs prohibited in competitions includes pain inhibitors such as morphine. A research group at the Turin University has now found an agent generating the same effects in the body as the opioid but will never appear on the black list of the doping agency WADA: Physiological saline solution, injected intramuscular. We are not talking homeopathy but preconditioning. For many years, Fabrizio Benedetti and his team are working on the secrets of sugar pills and saline solutions. Their field of work: The effects of placebos. In the Journal of Neuroscience he asked the question: Can repressing of pain and increase of performance by placebos be considered doping?

Pain-training with opioids

Fabrizo Benedetti looked for 40 amateur athletes of age +/- 25. He set up four teams competing with each other in simulated competitions. The issue was to torment yourself and stand the pain as long as possible. For this purpose he interrupted the blood circulation of the upper arm of the patient with a tourniquet. The athlete now was supposed to push spring dumbbells as long as possible. The ischemia induced pain rises severely. After about 14 minutes it is unbearable. Prior to the “contest”, the participants had a three-weeks training with one test pushing per week. Two teams got morphine during the preparation period which increased their pain tolerance from about 14 minutes to 23 minutes. Benedetti changed the treatment protocol for the actual match. Only group 1 had to train as well as compete without the injection. The other teams got their shots. They were told that the shot was morphine meant to increase their tolerance. In fact only one of the morphine trained groups got Naloxon, an opioid-antidote. The other two groups got injections of 0.9 percent saline solution.

All groups were able to increase their pain tolerance by training. The placebo effect was particularly obvious in the group where the breaking point was pushed up by pain killers. They reached an increase of about 6 minutes compared to when they started the training. But the participants without the prior support of morphine increased their condition as well by about 2 minutes compared to the preparation time by the supposed pain blocker, while the group wit the antidote only reached the time of that group without any morphine or placebo.

Placebo-doping: Legal and not traceable

In earlier tests Benedetti already found out, that his experimentees were influenced by several doses of opiates to such an extent that the placebo was able to replace the opiate when it got serious. He was able to cause such a placebo effect with two doses within only two weeks. To prepare cycling races or other competitions depending on the conquest of the inner swine, this type of “placebo doping” would be legal and not traceable during the competition since morphine has a very short half life in the body. The doping agency WADA is concentring on the topic now as well. The chief physician Alain Garnier commented in the New Scientist: “It is not an easy problem”. It might happen in the future that – during doping tests – the lie detected is added to the urine tube for bicycle racers being helped to the yellow jersey with sugar pills and saline solution.